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Friday, April 9, 2010

MiM Mailbag: Maternity leave for residents

Editor's note: Any reader who has experience with this is welcome to post her answers to the questions below (i.e., not just limited to MiM's bloggers!).

I was happy to find your site today. I'm a physician in academics and the issue of maternity leave for residents is important to me for two reasons. I was the first woman in my program to have a baby as a resident and, now that I am faculty, I feel some responsibility to help the female residents navigate motherhood during their training.

One question for your bloggers: How commonly have women had to extend their training due to maternity leave? Was this due to taking longer than the 6 weeks allowed by the specialty's academy or the hospital (or maybe it's longer for some specialties)? Or were some women required to "make up" the weeks they missed, even if they only used 6 weeks of maternity leave? At our hospital, it appears that there are different standards in different departments. Some faculty are concerned that women are missing too much time in their training, especially if they deliver during chief year.

11 comments:

I had my daughter at the very end of my second year of neurology residency. I was allowed to use my accumulated 6 weeks of "sick time" (2wks/yr) and 1 weeks of vacation. I think I was out for 7 weeks total after my c/section. Any more and I would have had to make up time at the end of the year. I was not required to. I lost a month of elective time and had to complete all my required rotations during the remainder of the year.

This is a topic near and dear to my heart! I was recently involved in a task force on the accomodation of the pregnant physician that the British Columbia Physician Health Program initiated. The report was just released lastmonth - here is the link to the PDF:

From a personal experience I took a year of mat leave, transferred from internal to family medicine, and joined the cohort behind me. Taking longer mat leave is (becoming more common up here in Canada it seems but there is variable support for that within different residency programs!

I took 8 weeks off, and had to make up 2 weeks at the end of residency. For 1 month of my maternity leave I was doing a rotation called "History of Medicine" that required for me to read books and articles, write papers, and meet with the instructor on a regular basis. I also lost my chance to go on an international rotation which I was already accepted for, since it was thought to be a non-hard core rotation, even though a male colleague of mine had a similar number of "fluff" rotations as me. That last item I am still bitter about, as you can tell....

I started my residency a month early in order to extend each of my (two) maternity leaves from 6 to 8 weeks. I was lucky it was an option at the time - they had extra $$ to pay me back in good economy (on the surface, at least) days.

Still got hard and heavy questions from some of the faculty toward the end of my training about whether I had accumulated enough rotations to take my boards and start my fellowship. Luckily, I was able to defend my position with evidence (coming from a place of anger and defensiveness, I might add). Damn it, I planned well.

I did a civilian US residency, and, if I hadn't been pulled from work for bedrest due to pre-term labor, I would have been able to finish without working any extra time. However, even with 6 weeks of maternity leave and 4 additional weeks off for PTL, I took no vacations most of my 3rd and all of my 4th year, worked 2 additional weeks, and still graduated with my fellow resident class. So, it can be done, but it is a tight squeeze sometimes! :)

At the place where I trained, it's different from department to department. I was out on bedrest for 10 weeks and 3 weeks of maternity, which was totally barbaric. I was also one of very few people to ever have had a baby in this program. The director consulted with the board of our specialty and they came up with this solution where I made up a month at the end, and gave up all my vacation so that my total time missed from the program for any reason was less than 6 weeks per year. This was a major headache and required a lot of running around and sucking up to people. I still feel that there was a big element of leeway that the program director had in deciding whether I would be able to graduate that year, and that they used it to make me come back to work way too early. I think it would be a good thing for all specialty boards to come up with some binding regulations that make the whole process at least somewhat accountable.

My understanding of the ACGME requirements when I was an internal medicine chief resident 3 years ago, was that one needed to make up for time away for whatever reason, if they missed more than 4 consecutive weeks. How much time you actually got off then depended on institutional and departmental policy which in reality was determined by staffing needs. I don't know if this applies to other specialties or even how much things may have changed over the years.

While I did not have a baby during my residency, 9 residents or their wives did during that year, which made for a pretty interesting time as far scheduling was concerned. Fortunately for them, the atmosphere in this program was very family friendly and we were able to creatively cater for the different individual needs.

I'm currently an academic Fam Med attending, only 2 months back from maternity leave after my 2nd baby. I had my 1st child in march of 2nd yr. I took ~6.5 wks off - 4 of which was paid incl 2 of accrued vacation. I didn't pursue forgoing any vacation of my 3rd yr (didn't get offered, wouldn't have wanted to really). I had to make up most of the time - was considered a 2nd year for an extra month (that July) compared to my class, so had to make up 4 wks at the end to do the full 3rd year. It was explained as required because of academy rules. At the time, it seemed that residents from other departments didn't have to make up that much of their maternity leave but I don't know if that's true.

maternity leave in america, for any working woman, is barberic and for residents/fellows is even worse. and am i imagining this or do pregnant residents/fellows have more prenatal complications then the average working woman??? there must be a study on this out there somewhere.

I got pregnant during the 3rd year of my EM residency. I had hyperemesis so bad I had a PICC w/ TPN from about the 6th week of pregnancy to the 16th. I'm pretty sure that I didn't work for at least 4 weeks, possibly 8 weeks during this period. Being 9 years out of residency, and not having had to make up any of the time (thus no drama really)I can't recall exactly how much time I missed, except that it sucked up all my elective time. I still was able to get all my required rotations done. I delivered during another elective rotation, stayed home for 2 weeks, and was back to work. However, my daughter was born in mid-April. So after graduation a month later (I did not get held back), I was able to take a couple of months off before starting my new job. Also, my husband quit work and became a stay-at-home dad when I delivered, so returning to work at 2 weeks was possible and not that hideous.

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